The rollout of swabs and tubes will happen simultaneously but is scheduled in phases, aligning with the broader pathology services transformation programme. Specific go-live dates will be communicated to each site in advance. Phased rollout began in November, starting with primary care, to be followed by the Trusts.

This rollout is happening across the world and the closest to your locations would be South West London Pathology (SWLP), which completed the Σ-TRANSWAB MRSA change earlier this year and is now changing to the Wound Swabs (Σ-TRANSWAB®). Some GPs in Southwark and Lambeth – as well as secondary care colleagues at Guy's and St Thomas' NHS Foundation Trust – have already been using the type of boric acid urine tubes we will be introducing for some time.

Liquid swabs allow for automated processing, reducing manual handling, increasing testing speed and improving accuracy in microbiology diagnostics.

The current TRANSWAB® is a gel and the newer Σ-TRANSWAB® is a liquid swab, so contains no agar. The other main difference for MRSA testing is the current double or triple MRSA process (depending on your current clinical process) will move to a 2 in 1, or 3 in 1, sample process.

The way you order consumables will not change, but the product codes will.

A phased approach will be taken to ensure a smooth transition. We are working with procurement teams to ensure robust arrangements are in place throughout. We advise that you run your old stock down as you usually would for a change of this nature.

Yes, gel swabs and old urine bottles will still be processed for a limited time post-rollout to support the transition period. However, you should cease ordering this stock with immediate effect following your switchover date, after which old stock will no longer be available to order.

Yes – see above.

The new swabs contain a liquid which is the key component for testing, therefore it is important that it is not spilled. If it is, you will need to start the swabbing process again. The laboratory cannot use a dry swab.

The other main difference is that the current pre-admission/pre-assessment triple or double MRSA process (depending on your current clinical process) will move to a 2 in 1 (KCH), or 3 in 1 (GSTT) sample process, which is quicker and more precise.

It works by a) swabbing the first site (e.g. groin) with a red swab and swishing it in the liquid, before  discarding it; b) repeating this process for the second site (e.g. armpit); and c) swabbing the final site with the white swab (e.g. nasal), putting it in the vial, snapping off the non-swab end and screwing on the vial cap, leaving just one swab and sample within.

Yes, the nasal swab must be collected last to prevent cross-contamination. The order of groin and armpit swabs can be flexible.

Use a sharps bin or other designated biohazard disposal.

There may be a risk of spillage, as the new swabs contain a liquid rather than a gel. However, there are no hazardous materials present in the swab. If there is a spill, we suggest you use a new swab and vial to ensure the correct results, as it is the liquid element we need to be able to perform automated testing in our laboratories.

If the liquid is spilled, the test cannot be conducted, as the liquid medium is essential for processing the sample.

There are no new risks, other than if the red swabs used for the MRSA testing are left in the Σ-TRANSWAB® Liquid when sent to the labs, this would render the test as void. Only the white (nasal) swab should be left in the tube.

The same precautions for the gel and Σ-TRANSWAB® Liquid swabs should be taken (i.e. wear gloves and dispose of the waste safely).

Please send three separate swabs, one for each location being screened. Use the single, purple-topped liquid swab for each site to ensure accurate individual results.

No. Liquid swabs are designed for direct use and do not need to be pre-moistened. Use the swab as provided in the kit.

Use the new purple-topped liquid swab for any test that involves a single-swab process. These swabs will replace the current blue and black-topped gel swabs for all microbiology culture swab tests, e.g. wounds, nasal, genital and throat, and are designed for optimal sample preservation and processing.

The only exception to this is for sexual health screening. If a gonorrhoea culture is required and for susceptibility testing, you should continue to use black-topped charcoal swabs. You should also continue to use these swabs for newborn eye testing, if Neisseria gonorrhoeae is suspected.

No, you should continue to use the Aptima CHCG swabs for chlamydia. Similarly, green viral swabs are not changing.

Yes. Printable patient information sheets are available to guide patients through the self-swabbing process and can be given to the patient along with the swab. These include clear instructions and diagrams for correct sample collection and can be downloaded here.

Yes. If immediate transport to the laboratory is not possible, liquid swab specimens can be stored in a refrigerator overnight. Please ensure they are sealed properly and kept at the correct temperature. Samples should be sent to the laboratory as soon as possible the next day to maintain their integrity.

Training sessions are taking place ahead of each site's rollout. The training covers correct collection procedures for the new swabs and best practices for handling liquid swabs. Training videos are available (see top of this page), and the new equipment supplier will train Practice Development Nurse Team (PDNs), who will then cascade knowledge to nursing staff across Trust sites and in the community. For primary care colleagues who need further support, we would be delighted to come along to meet you at practice nurse forums. Please email Synnovis Clinical Governance Lead, Carol Macfarlane, on carol.macfarlane@synnovis.co.uk to make the necessary arrangements.

Training will be delivered through a combination of on-site sessions, webinars and recorded instructional materials to ensure accessibility across all sites.

Yes, each Trust has worked with the supplier to tailor training approaches based on site needs, workforce size and logistical constraints.

24 October - Switchover dates confirmed and first webinar recording

17 October - Introduction to new Liquid Swabs and Urine Tubes

24 October - Go-live date and webinar recording video

17 October - Introduction to new Liquid Swabs and Urine Tubes

24 October - Go-live date and webinar recording video

17 October - Introduction to new Liquid Swabs and Urine tubes

24 October - Go-live date and webinar

17 October - Introduction to new Liquid Swabs and Urine tubes

24 October - Go-live date and webinar

17 October - Introduction to new Liquid Swabs and Urine tubes

Boric acid helps to preserve urine samples for microbiology testing by preventing bacterial overgrowth. This ensures more accurate culture results, especially when there is a delay between collection and processing.

We are standardising the type of urine tubes used across all Synnovis services by introducing green-topped boric acid tubes, helping to bring consistency for all service users. If you are already using these tubes to send samples for processing, you won’t need to do anything different. However, if you are using either red-topped boric acid or white-topped plain universal containers, you will need to switch to the green-topped boric acid tubes for all microbiology urine samples following your switchover date.

No. White-topped plain universal containers should continue to be used for other urine tests, e.g. biochemistry Albumin Creatinine Ratio (ACR), urine protein and osmolality. This is because boric acid renders these tests unsuitable for analysis.

Do not use the boric acid tube for pregnancy or chemistry tests. Boric acid is a preservative intended for microbiology (culture) testing only and may interfere with other test results.

If multiple tests are required:

• Collect urine in a standard sterile collection cup.
• Draw off the urine for microbiology testing first using the inbuilt syringe in the green boric acid tube
• Perform the pregnancy test (or other non-microbiology tests) using fresh urine.

Healthcare staff or carers may assist with transferring urine from the collection cup to the boric acid tube using the syringe, where possible. If self-collection is required, provide clear step-by-step instructions. For patients with severe mobility or dexterity issues, consider arranging for sample collection during a home visit or in a clinic setting.

Yes. A sterile collection cup is essential to prevent contamination of the urine sample, which could lead to inaccurate test results. Patients should be advised to always use a sterile container provided by the clinic or purchased from a medical supplier. They should not re-use household containers or non-sterile cups.

Samples should be stored at room temperature – do not refrigerate unless specifically instructed by your local protocol. Avoid exposure to direct sunlight or extreme temperatures.